Healthcare systems worldwide are striving for the “quadruple aim” of better population health and... more Healthcare systems worldwide are striving for the “quadruple aim” of better population health and well-being, improved experience of care, healthcare team well-being (including that of carers) and lower system costs. By shifting the balance of care from reactive to preventive by facilitating the integration of data between patients and clinicians to support prevention, early diagnosis and care at home, many technological solutions exist to support this ambition. Yet few have been mainstreamed in the NHS. This is particularly the case in English coastal areas which, despite having a substantially higher burden of physical and mental health conditions and poorer health outcomes, also experience inequalities with respect to digital maturity. In this paper, we suggest ways in which digital health technologies (DHTs) can support a greater shift towards prevention; discuss barriers to digital transformation in coastal communities; and highlight ways in which central, regional and local bo...
In the face of concern over high caseloads, cuts to services, stress and burnout, researchers Oli... more In the face of concern over high caseloads, cuts to services, stress and burnout, researchers Oliver Beer and Professor Sheena Asthana of Plymouth University decided to investigate the health and wellbeing of practitioners in England. Here they share their findings.
What Causes Stress in Social Work? (England, UK). Researchers Oliver Beer and Professor Sheena As... more What Causes Stress in Social Work? (England, UK). Researchers Oliver Beer and Professor Sheena Asthana of Plymouth University, UK, decided to investigate. They surveyed 427 social workers in England, UK, and here is a brief look at what they discovered.
Purpose Neo-liberal “reform” has in many countries shifted services across the boundary between t... more Purpose Neo-liberal “reform” has in many countries shifted services across the boundary between the public and private sector. This policy re-opens the question of what structural and managerial differences, if any, differences of ownership make to healthcare providers. The purpose of this paper is to examine the connections between ownership, organisational structure and managerial regime within an elaboration of Donabedian’s reasoning about organisational structures. Using new data from England, it considers: how do the internal managerial regimes of differently owned healthcare providers differ, or not? In what respects did any such differences arise from differences in ownership or for other reasons? Design/methodology/approach An observational systematic qualitative comparison of differently owned providers was the strongest feasible research design. The authors systematically compared a maximum variety (by ownership) sample of community health services; out-of-hours primary ca...
BackgroundAn ageing population, the increasing specialisation of clinical services and diverse he... more BackgroundAn ageing population, the increasing specialisation of clinical services and diverse health-care provider ownership make the co-ordination and continuity of complex care increasingly problematic. The way in which the provision of complex health care is co-ordinated produces – or fails to produce – six forms of continuity of care (cross-sectional, longitudinal, flexible, access, informational and relational). Care co-ordination is accomplished by a combination of activities by patients themselves; provider organisations; care networks co-ordinating the separate provider organisations; and overall health-system governance. This research examines how far organisational integration might promote care co-ordination at the clinical level.ObjectivesTo examine (1) what differences the organisational integration of primary care makes, compared with network governance, to horizontal and vertical co-ordination of care; (2) what difference provider ownership (corporate, partnership, p...
Main results: There is substantial variation in the relative importance of the age and class dist... more Main results: There is substantial variation in the relative importance of the age and class distributions of different diseases. Age effects often overshadow those of class even for conditions where an apparently strong social gradient exists. Only for self reported mental health among ...
Notwithstanding the recent change of government, UK educational policy continues to stress school... more Notwithstanding the recent change of government, UK educational policy continues to stress school performance tables, parental choice and competition reflecting an acceptance by New Labour of Tory notions concerning the role that market mechanisms play in improving ...
Healthcare systems worldwide are striving for the “quadruple aim” of better population health and... more Healthcare systems worldwide are striving for the “quadruple aim” of better population health and well-being, improved experience of care, healthcare team well-being (including that of carers) and lower system costs. By shifting the balance of care from reactive to preventive by facilitating the integration of data between patients and clinicians to support prevention, early diagnosis and care at home, many technological solutions exist to support this ambition. Yet few have been mainstreamed in the NHS. This is particularly the case in English coastal areas which, despite having a substantially higher burden of physical and mental health conditions and poorer health outcomes, also experience inequalities with respect to digital maturity. In this paper, we suggest ways in which digital health technologies (DHTs) can support a greater shift towards prevention; discuss barriers to digital transformation in coastal communities; and highlight ways in which central, regional and local bo...
In the face of concern over high caseloads, cuts to services, stress and burnout, researchers Oli... more In the face of concern over high caseloads, cuts to services, stress and burnout, researchers Oliver Beer and Professor Sheena Asthana of Plymouth University decided to investigate the health and wellbeing of practitioners in England. Here they share their findings.
What Causes Stress in Social Work? (England, UK). Researchers Oliver Beer and Professor Sheena As... more What Causes Stress in Social Work? (England, UK). Researchers Oliver Beer and Professor Sheena Asthana of Plymouth University, UK, decided to investigate. They surveyed 427 social workers in England, UK, and here is a brief look at what they discovered.
Purpose Neo-liberal “reform” has in many countries shifted services across the boundary between t... more Purpose Neo-liberal “reform” has in many countries shifted services across the boundary between the public and private sector. This policy re-opens the question of what structural and managerial differences, if any, differences of ownership make to healthcare providers. The purpose of this paper is to examine the connections between ownership, organisational structure and managerial regime within an elaboration of Donabedian’s reasoning about organisational structures. Using new data from England, it considers: how do the internal managerial regimes of differently owned healthcare providers differ, or not? In what respects did any such differences arise from differences in ownership or for other reasons? Design/methodology/approach An observational systematic qualitative comparison of differently owned providers was the strongest feasible research design. The authors systematically compared a maximum variety (by ownership) sample of community health services; out-of-hours primary ca...
BackgroundAn ageing population, the increasing specialisation of clinical services and diverse he... more BackgroundAn ageing population, the increasing specialisation of clinical services and diverse health-care provider ownership make the co-ordination and continuity of complex care increasingly problematic. The way in which the provision of complex health care is co-ordinated produces – or fails to produce – six forms of continuity of care (cross-sectional, longitudinal, flexible, access, informational and relational). Care co-ordination is accomplished by a combination of activities by patients themselves; provider organisations; care networks co-ordinating the separate provider organisations; and overall health-system governance. This research examines how far organisational integration might promote care co-ordination at the clinical level.ObjectivesTo examine (1) what differences the organisational integration of primary care makes, compared with network governance, to horizontal and vertical co-ordination of care; (2) what difference provider ownership (corporate, partnership, p...
Main results: There is substantial variation in the relative importance of the age and class dist... more Main results: There is substantial variation in the relative importance of the age and class distributions of different diseases. Age effects often overshadow those of class even for conditions where an apparently strong social gradient exists. Only for self reported mental health among ...
Notwithstanding the recent change of government, UK educational policy continues to stress school... more Notwithstanding the recent change of government, UK educational policy continues to stress school performance tables, parental choice and competition reflecting an acceptance by New Labour of Tory notions concerning the role that market mechanisms play in improving ...
What Causes Stress in Social Work? (England, UK). Researchers Oliver Beer and Professor Sheena As... more What Causes Stress in Social Work? (England, UK). Researchers Oliver Beer and Professor Sheena Asthana of Plymouth University, UK, decided to investigate. They surveyed 427 social workers in England, UK, and here is a brief look at what they discovered.
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